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Gonadotropin Ovarian Stimulation Aboubakr elnashar elnashar53hotmail

ContentsTypes of ovarian stimulationsTypes of GntPatient selectionIndicationsContraindicationsProtocolsMonitoringResultsComplicationsConclusion. Types of ovarian stimulationInduction of ovulation: To induce monofollicular development in anovulatory patientsSuperovulation: Intenti

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Gonadotropin Ovarian Stimulation Aboubakr elnashar elnashar53hotmail

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    3. Types of ovarian stimulation Induction of ovulation: To induce monofollicular development in anovulatory patients Superovulation: Intentional production of more than one mature follicles

    4. Controlled ovarian hyperstimulation (COH): Regulated superovulation by turning off the patient’s own hormones (down regulation) followed by stimulation 1. Multiple follicles growth. 2. Control timing of ovulation: ova can be retrieved before they are ovulated. 3. Prevention of premature LH surge.

    17. Ready to use pre-filled pen Rec Consistent FSH in terms of protein content (Bassett et al, 2005). More precise dose More consistent ovarian response: less treatment days less cancelled cycles Better embryo quality Higher implantation rate (Hugues et al.,2002 Balasch et al, 2004) Pen: Easy to use Patients prefer prefilled pen (Weiss et al, 2007)

    30. Protocols Dose& duration vary among Women: extremely sensitive to relatively low doses (75-225 IU daily), others require greater stimulation (300-450 IU daily). B. wt & dose Response cannot be predicted, even in the obese. 2. Cycles within women The intended goal: unifollicular ovulation or superovulation?.

    31. I. Step-up: 1. Conventional=Standard 2. Low dose 3. Chronic low dose II. Step-down III. Step-up, step-down

    32. I. Step up Principle: Stepwise increase in FSH {determine the FSH threshold for follicular development}

    33. Conventional: Starting dose: 150 IU/d: Duration of starting dose: 5 d Increased by: 75 IU/3-5 d Excessive follicle development Increased OHSS (Thompson and Hansen, 1970; Dor et al., 1980; Wang and Gemzell, 1980). No longer recommended (Buvat et al., 1989; Brzyski et al., 1995)

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